Madness

There are several books about bipolar disorder—manic depression—that I believe are must-reads, if you happen to be in the unfortunate situation of trying to comprehend this nearly unfathomable illness. Here are two:

An Unquiet Mind, by Kay Redfield Jamison

Madness: A Bipolar Life, by Marya Hornbacher

There are others, far more clinical and practical in tone, but these two autobiographical accounts hit this crooked nail on the head, often with humor and smarts, and without self-pity.

I turn to these books when my own demons begin acting up again—despite medication compliance, despite what the docs like to refer to as “sleep hygiene” (regular sleep patterns), despite the whole rigamarole of being a well-behaved bipolar bear.

The meds can work for a time, then decide they’re through with you. You have little say in this. Most bipolar folks, after being diagnosed, spend a lifetime of tweaking meds with their doctor, trying to get them “right.”

Sadly, like life, there is no permanent “right.” The pain and frustration of trying to follow the rules, trying to be “good,” knowing that your loved ones are holding their breath each day over your fate—it is exhausting and sickening, and feels anything but a “right” way to live.

I know I’m slipping some. I know because I see faces. Terrible faces. (Cue the “I see dead people” quip, yes, yes, get it out of your system, aren’t you funny! My!) The faces let me know that my brain is protesting, that the meds will soon need another round of adjusting. When I close my eyes, the faces are stunning in their detail, and make sleeping more difficult than it already is, even with the medication. Sometimes, they stare directly at me, leering, or simply studying me. Other times, they morph into gory scenarios beyond my capability of imagination. I am entranced but terrified.

My voice is (so far) the only voice I hear, but it becomes cruel. It lets me know in no uncertain terms that I am wretched, that I am wrong through and through, that I have nothing to offer to anyone in this lifetime. One look into my little girls’ eyes, and I know that is not—cannot—be the case. My heart and soul tell me this, and they are strong. But when the voice becomes louder, more insistent, the fear kicks in. I become paralyzed. I start at every simple noise, my heart pounding. Nothing, nowhere, feels safe.

And so I call the doctor. I try to speak the truth to those that I love, and who love me. I do my best not to let fear get in the way of the truth. Whatever “truth” is. I try not to pretend that all is well. This is no easy feat, after a lifetime of pretending.

When the bite-sized pieces of madness begin assembling themselves in my mind—another face, another vicious voice—soon I cannot remember what I have told others, what they have told me. Memory is one of the first faculties to go, in bipolar disease, making us exceedingly frustrating, irritating people to have around. Trust me: we are horrified by all the gaps in our memory, by what we cannot remember. Our brains are simply racing too fast to make sense of your words, or our own thoughts. Or, our brains are shutting down once again, turning into miserable slugs. We cannot imagine what good it will do to be near you, with slugs for brains. So we hide.

I have said this before: if you have a bipolar bear in your life, or suspect that you do, be kind, oh, be kind. The illness is selfish and takes what it wants, but the bipolar person is usually trying her best to keep moving, keep going, be someone of value. Bipolar disease is a constant death match—a fiery brain at war with itself, burning itself to ashes.

What can you do? What should you do, if a loved one struggles in this dark, ugly place—manic depression that is not responding to medication, or likely manic depression that has not been diagnosed or treated?

Asking too many questions is confusing, and reminds a bipolar bear how little he can recall, just how flawed he is. Tread gently, as you would around a real polar bear. Arrange the meds in pill cases. Offer to call the doctor, the dentist, during rough periods. Confirm appointments. Surreptitiously check limbs for signs of cutting. Take a look at sinks and counters for signs of too much self-medicating with alcohol. Walk dogs, feed cats. Bring food and sit with your bear and share a meal. Clean the kitchen. Remember that emotional triggers can really knock a bipolar bear out of whack and convince them that the grief will never leave: “anniversary” dates of difficult moments in time; seemingly simple things like jetlag; sending the kids to the ex-spouse’s home for a spell.

Always: Keep lines of communication open; leave judgement at the door with your shoes.

Again: there is no “right.” There is nothing right about a disorder that convinces the one you love that she is appalling, vile, hideous, guilty as charged and not charged of everything wrong in the universe. There is nothing right about a disorder that persuades the one you love that he can (and must!) work 90 hours a week as a copywriter, to save the human race, and then go out drinking all night, in search of sex and drugs—because the brain says, Yes! Yes! This is living! You must live!

It is a tragicomic disease, until the comedy flees and only tragedy is left in its wake. The suicide rate for bipolar bears is staggering. If you are in over your head with a beloved bipolar, do not hesitate to get help from a crisis team. When your bipolar loved one becomes unrecognizable to you, yes, it is time. It may be time, before that point, but who can say? There are stubborn bears. They don’t want you to know how bad it’s gotten. They want to be like you. They want to be good, calm, normal, successful—like you. Like they think you are. Roll your eyes if you must, but your life looks pretty damn good from the bipolar bear’s point of view.

There is simply no “right” here. There should be. There just isn’t.